EPI Question - Page 1

Our 13 month old was just diagnosed with EPI yesterday.  Her cTLI was <1. 

I know this is an international list and was wondering if there were any Germans on here who could help me.  We are Americans living in Germany so the language barrier is an issue right now.  The vet currently has her on Royal Canine Intestional...this is soooo expensive and I haven't heard great things about it.  Does anyone know of a good German dog food that is sold in the German stores that would be good for an EPI dog?


Also I am curious of anyone with an EPI dog what their experience has been so far and how their dog is doing?  We are concerned that her cTLI is so low, she also is still acting crazy hungry despite getting 6 cups of food a day and the enzymes.  Her poop is less frequent and much more solid but still yellow.  She is currently getting 7.5 tsps of Pancrex powder a day.  She is also on an antibiotic for SIBO.  She has also become very nervous about going out.  She'll pace around the house for ages but refuses to go out.  She has been drinking much more water lately but isn't peeing much, mostly I think because she won't go out.   She has also started chewing at her feet.

Thanks,

Louise

Louise

I really feel for you - we had a bitch who suffered from EPI and it seemed like a huge mountain to climb.  Initially we thought we'd never get her stabilised, but we did and after 2 years we actually were able to stop feeding the enzymes.  You need a food that is very low in fat, we found in the UK a greyhound formula that would ideal and suited our girl down to the ground.  Also dont give treats as so many of those are very bad.  IF you want to treat either use her food or something like a chunk of carrot.

The chewing feet thing could just be a stress side effect or that she is slightly allergic to the feed that the vet has recommended.  If it is an allergy thing I would be inclined to use aloe on her feet and get liquid aloe for her diet - this is something I did for an itchy bitch and it resolved the problems very quickly.  I also used Bee Propolis to help with the healing of the sores created by the chewing/scratching.

As for long term prognosis our girl was diagnosed at 1 and then went on till she was 10 years old and had very few problems once the epi was treated.

I have heard that some dogs are not as sound mentally after EPI but this is only what I've picked up on the forum, not personal experience.

Good Luck

The TLI is typical of a dog that has EPI.  The pancreas stops functioning at about 95% of tissue loss.  The remaining five percent can affect the TLI result and just may mean she was asymptomatic for a while longer than most as can what she had been eating the day or two before.   It does not nessecarily mean that the dog is in worse shape than one <1.   My male was tested three times, 5, 3.2 ( two years ago) and most recently 1.  He went from a 95 lb power house to a 72 lb skin and bone junk yard dog with a hazardous temperment.  Touch him and he freaked he felt so bad.  He was first put on a perscription diet that was very expensive (Purina Gastro formula).  I switched him to a senior food following the advice on the EPI yahoo groups rule of thumb on nutrient anounts.  The rule of thumb has been <4% fiber, <10% fat and go from there.   I was able to get him stabilized on this and then went to Canidae which worked great till they changed the formula.

 However, there have been some studies and experience from member of the EPI group on Yahoo that show they do better on a raw diet or a high protien diet.  All of the three base nutrient digestion is affected by EPI.   Fats just seem to logical to ommit since they are harder on the intestine.  Raw diets assist the dog becuase the natural enzymes are also available from the food (theorhetically).

I have had success with just about any holistic food, Blue Buffalo being the best now, but he did very well on canidae till they changed the formula.   He has been fairly easy to stabilize and control.  He does have "episodes".  I tend to wait and see if they are long term or just for a day or two before I increase enzymes or seek antibiotics for SIBO.

For her skin, did they do a B12 test (colbalbumin) she may need some B12 shots to help her skin.

My dogs temperment has gotten better, I know when he is having a bad day more by his attitude then his stool!  His stomach must just give him that much pain. 

Your dog seems to be on a lot of enzymes, however, I am not familiar with the strenght of that product.  Could she be getting too much causing a painful bowel movement?  Still runny with a high pH causing buring in the rectal area??

I also had an EPI Shepherd (West German Showline: his owner abandoned him at the vet's office boarding as a pup when he was diagnosed).  The veterinarian wasn't familiar with proper feeding requirements of an EPI dog so when I got him, he was 10 mths old and 46 lbs.  Within a few weeks and a few months after feeding him with adding enzymes into his food, his weight became normal.  He was never a large dog, but he maintained a healthy weight.

I am not German, and I do not live in Germany so I don't know what to recommend to you besides what others have said: diets low in fiber and low in fat.  Royal Canin is not good food, and by the sounds of your dog chewing its feet, it sounds like food allergies. 

All I can say is hang in there! If she was just diagnosed yesterday, it'll be a little while before the feeding, enzymes, etc. take effect.  She could be worried about going outside because her digestive system hasn't "righted" itself yet, and she is still having diarrhea or runny defecation.

 Louise,

You emailed me privately and I sent some suggestions via a reply. I never heard back from you. I have many more and many specific suggestions if you want to respond to my prior private email. But it is not a "one shoe fits all" scenario often and therefore I have to ask a lot of questions. 

The dog can probably be stabilized and will do much better once you have her on some sort of enzyme replacement.

Good luck.

Thanks for the responses...Hodie, I emailed you.

I'm starting to wonder if Royal Canine is a good food...it is Royal Canine Intestional and the vet gave it to us but when I looked on the bag it is 20% fat, and the regular Iams that she was on before is less fat than this, at 15%.  This seems strange to me!  I'm wondering why we are paying 4 times as much for this Royal Canine when Iams seems like it will work just as well.  Sigh, I guess this is going to be a long few months.

Bumping, in case there is anyone out there familiar with German dog food brands.

Louise

Seems like way too much fat from my understanding of the diet.  What kids of fat are they?  Oils like coconut oil and other short chain molecules are supposed to be better for them and easier to digest.

Iams is also not a good food.  It is primarily full of fillers. 

Many  EPI owners also use probiotics, and Prozyme, a plant based enzyme (along with the porcine enzyme), to help stabelize their dog.

I tried the low fat dog foods, but have found that eventually my boy can tolerate higher fat ratings.  Timberwolf was the food mine did best on, but the cost became prohibitive.  Canidea also was good with him.  It took several food trials to find one that worked for him.

I'm not sure if they're available in Germany or not. 

Tylan is also something my boy needed at first to combat SIBO, and he needs it occasionly now, when the SIBO has a flare up.

The variety of Royal Canin you are feeding the dog is the wrong thing. If it is 20% fat, that is way too high. Indeed, this is one of those counterintuitive situations where one can easily make mistakes in treatment. One sees a thin dog and immediately thinks of "fattening" the dog up. But it is exactly the fats that the dog cannot digest and metabolize properly and which causes all the gas, loose stool and weight loss. So find a food that is 11% or less if possible. Fiber content also can be an issue, but some dogs do well just on changing the fat content of their meals alone.

 Also, adding a canned food that is much less fat, such as Wellness at 5% or something no more than about 8% to meals will help. Never feed too much in one meal as that only worsens the problem. 3 cups of food, dry measure, with her at a time should be sufficient. If she does not need to go out at night because of it, you may try adding a meal at lunch. So in other words, giving her three meals a day. But in measured proportion!

The amount of enzyme does seem high, but not knowing the brand and the strength makes it difficult to assess. However, yes, giving too much can also result in problems. Remember, these enzymes digest tissue, so too much can cause all kinds of problems, including burned tissue in the mouth.

I just sent you an email with some other questions and suggestions. Whatever you do, you must be patient. It seems based on your private email to me that you may now be on the right track. It will take some time to adjust everything to where it must be to properly maintain the dog, but she likely can be maintained and live a good life now that the problem is identified.

Email me a response to my questions as soon as you have time.